Imani Farnad, Hemati Karim, Rahimzadeh Poupak, Kazemi Mohamad Reza, Hejazian Kokab
Professor, Department of Anesthesiology, Pain Fellowship, Rasool Akram Hospital, Iran University of Medical Sciences , Tehran, Iran .
Associate Professor, Department of Anesthesiology, Pain Fellowship, Imam Khomeini Hospital, Ilam University of Medical Sciences , Ilam, Iran .
J Clin Diagn Res. 2016 Jan;10(1):UC09-12. doi: 10.7860/JCDR/2016/14476.7035. Epub 2016 Jan 1.
Stellate Ganglion Block (SGB) is an effective technique which may be used to manage upper extremities pain due to Chronic Regional Pain Syndrome (CRPS), in this study we tried to evaluate the effectiveness of this procedure under two different guidance for management of this syndrome.
The purpose of this study was to evaluate the effectiveness of ultrsound guide SGB by comparing it with the furoscopy guided SGB in upper extermities CRPS patients in reducing pain & dysfuction of the affected link.
Fourteen patients with sympathetic CRPS in upper extremities in a randomized method with block randomization divided in two equal groups (with ultrasound or fluoroscopic guidance). First group was blocked under fluoroscopic guidance and second group blocked under ultrasound guidance. After correct positioning of the needle, a mixture of 5 ml bupivacaine 0.25% and 1 mL of triamcinolone was injected.
These data represent no meaningful statistical difference between the two groups in terms of the number of pain attacks before the blocks, a borderline correlation between two groups one week and one month after the block and a significant statistical correlation between two groups three month after the block. These data represent no meaningful statistical difference between the patients of any group in terms of the pain intensity (from one week to six months after block), p-value = 0.61. These data represent a meaningful statistical difference among patients of any group and between the two groups in terms of the pain intensity (before the block until six months after block), p-values were 0.001, 0.031 respectively.
According the above mentioned data, in comparison with fluoroscopic guidance, stellate ganglion block under ultrasound guidance is a safe and effective method with lower complication and better improvement in patient's disability indexes.
星状神经节阻滞（SGB）是一种有效的技术，可用于治疗慢性区域疼痛综合征（CRPS）引起的上肢疼痛。在本研究中，我们试图评估在两种不同引导方式下该操作对治疗这种综合征的有效性。
本研究的目的是通过比较超声引导下的SGB和荧光镜引导下的SGB，评估其对上肢CRPS患者减轻患侧疼痛和功能障碍的有效性。
14例上肢交感型CRPS患者采用随机分组法分为两组（超声引导组或荧光镜引导组）。第一组在荧光镜引导下进行阻滞，第二组在超声引导下进行阻滞。在正确定位针头后，注射5ml 0.25%布比卡因和1ml曲安奈德的混合液。
这些数据表明，两组在阻滞前疼痛发作次数方面无显著统计学差异，在阻滞后1周和1个月时两组之间存在临界相关性，在阻滞后3个月时两组之间存在显著统计学相关性。这些数据表明，在疼痛强度方面（阻滞后1周至6个月），任何一组患者之间均无显著统计学差异，p值 = 0.61。这些数据表明，在疼痛强度方面（阻滞前至阻滞后6个月），任何一组患者之间以及两组之间均存在显著统计学差异，p值分别为0.001、0.031。
根据上述数据，与荧光镜引导相比，超声引导下的星状神经节阻滞是一种安全有效的方法，并发症更少，患者残疾指数改善更好。
